Nursing Homes & Skilled Nursing Facilities

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Two of the most common health care services designed for seniors are nursing homes and skilled nursing facilities (SNFs). At first glance, they may seem the same. Each offers a place to stay while providing custodial and medical care. The two also offer many of the same types of amenities and services. Here's what you need to know about each:

Skilled Nursing Facilities

Nursing Homes

Smiling nurse and resident

A nursing home is a living option for seniors who do not need a hospital but require a higher level of care or medical attention than can be provided at home or in assisted living. Nursing homes provide structured schedules, meals, and around-the-clock medical treatment. Residents have care plans and receive regular health assessments. Nursing homes are regulated at both federal and state levels.

What types of care and services are offered in nursing homes?

Residents can expect to receive full-time health and personal care, as well as social and recreational activities. Though each location is unique, common types of care are skilled nursing, custodial, medication management, and therapies such as physical, occupational, and speech. Every nursing home also has 24-hour emergency care available. Living quarters, eating spaces, and activity centers are usually shared (though private quarters are commonly available at extra cost). Some of the standard activities included are game times, arts and crafts, and physical fitness classes.

Who works in a nursing home?

Nursing home employees often include a variety of custodial, medical, and other support staff. Here is a breakdown of who you may find working at a nursing home:

Administrators

An administrator manages the daily operations of their facility, ensuring that accommodations, staff, and state regulations are maintained safely and economically. They work directly with medical directors and nurses to ensure properly managed care plans.

Medical Directors

Medical directors are usually trained physicians who coordinate medical care for patients. They work directly with administrators, nurses, and other staff, to ensure that care plans are properly implemented.

Nurses

Registered nurses (RNs) and licensed practical nurses (LPNs) have duties that include, but are not limited to, health assessment administration, coordinating and providing patient care, medication management, wound care, and IV care. Federal law requires at least one RN on duty for 8 hours a day and either an RN or LPN on duty for 24 hours a day. Nursing education and licensing requirements vary by type. Most commonly, RNs require at least an associate’s degree, while LPNs necessitate a postsecondary program.

Physical Therapists

A physical therapist (PT) is a specialist that treats patients who are injured or ill with the objective of improving movement and/or managing pain. PTs consult with patients and other members of their medical team to provide support as devised by care plans.

Food Service Staff

Food service staff may have duties ranging from meal preparation to keeping the kitchen and eating spaces clean and compliant with any state regulations.

Dieticians

Federal law requires that nursing homes employ at least one dietician. Dieticians work directly with food service staff and nurses to plan and implement dietary programs for residents.

Personal Care Assistants

A Personal Care Assistant (PCA) is a staff member who helps patients with everyday needs such as bathing, eating, grooming, dressing, and toileting. PCA certification and licensing requirements vary by state and facility.

How much do nursing homes cost?

According to a report by Consumer Affairs, the national average cost of nursing home care is between $7,500 and $9,000 per month. Residents have a myriad of payment options to choose from including self-payment, long-term care insurance, VA benefits, Medicaid, and some life insurance policies. It is important to note that Medicare Part A will sometimes cover a portion of costs if the nursing home stay is short-term and for rehabilitation.

Skilled Nursing Facilities

Skilled Nurse giving resident in a wheelchair a shot in the arm

A skilled nursing facility (SNF) is a residential establishment for short-term medically necessary services. Residents receive 24-hour care from skilled nursing professionals, usually after a recent injury or illness. Residents may no longer require hospital care but might need medical management and monitoring, rehabilitation, or therapy. SNFs are licensed by the state’s Department of Health Services, but must also meet federal requirements “to receive payment under Medicare or Medicaid programs.”

What type of care is offered in a skilled nursing facility?

SNFs provide care to their residents for various needs, usually post-hospitalization. Facilities provide custodial care such as bathing, dressing, and help eating, as well as skilled nursing. Skilled nursing is defined as any type of medical care or treatment that can only be done by a licensed nurse. This includes, but is not limited to, wound care, IV therapy, and rehabilitation, such as physical or occupational therapy.

Who works at a skilled nursing facility?

Custodial staff commonly includes housekeeping, food service, and personal care. Medical staff varies depending on the establishment, but usually features a team of nurses, therapists, and medical directors. Here is a breakdown of who you may find working at a skilled nursing facility:

Nurses

Registered nurses (RNs) and licensed practical nurses (LPNs) have more than a few jobs in a skilled nursing facility. Duties may include, health assessment administration, coordinating and providing patient care, medication management, wound care, and IV care. Nursing education and licensing requirements vary by type. Most commonly, RNs require at least an associate’s degree, while LPNs necessitate a postsecondary program.

Speech-Language Pathologists

Speech-language pathologists are vital to SNFs, as they provide assessment and treatment for patients who have difficulty with verbal communication or swallowing. In seniors, these types of health challenges are often the result of dementia, stroke, or brain injury.

Audiologists

An audiologist is a doctor who treats ear-related issues including a patient’s hearing or balance. An audiologist works directly with patients and nursing staff and may prescribe certain therapies and hearing aids.

Personal Care Assistants

A Personal Care Assistant (PCA) is a staff member who helps patients with everyday needs such as bathing, eating, grooming, dressing, and toileting. PCA certification and licensing requirements vary by state and facility.

Food Service Staff

Food service staff may have duties ranging from meal preparation to keeping the kitchen and eating spaces clean and compliant with any state regulations.

Administrators

An administrator manages the daily operations of their facility, ensuring that accommodations, staff, and state regulations are maintained safely and economically. They work directly with medical directors and nurses to ensure properly managed care plans.

Medical Directors

Medical directors are usually trained physicians who coordinate medical care for patients. They work directly with administrators, nurses, and other staff, to ensure that care plans are properly implemented.

How much does a skilled nursing facility cost?

According to Genworth’s Cost of Care Survey, skilled nursing facilities cost around $260 per day (about $7,900 per month). Many health insurance providers will pay portions of SNF care, depending on your coverage. Medicare Part A will cover care in many circumstances, for instance, if SNF care is immediately followed by a qualifying hospital stay and a doctor recommends such additional care. Supplemental health insurance or veteran’s benefits are also potential payment help options.

Choosing nursing care near you

An important detail to consider is the geographic location of the nursing care you choose. Nursing homes and SNFs should be easily accessible to family members. Also, compare amenities and reviews to ensure you or your loved one is signing up for the best quality of care possible.

Visit the Senior Resource Nursing Care Directory to find care in your state!